America’s national birthday, July 4, celebrates our declaration of independence from tyranny in 1776. Enshrined in the historic Declaration of Independence document created by our founders are several inalienable rights of all people: life, liberty, and the pursuit of happiness.
The original Declaration speaks to us today. The right to life includes one’s good health; the right to liberty, one’s personal freedom of thought and action; and the right to pursuit of happiness, one’s full participation in all aspects of daily community life.
Today, we are engaged in a landmark effort to identify common ground for the best features of two very important pieces of proposed national mental health legislation. Recently, Representative Ron Barber (D-AZ; “Strengthening Mental Health in Our Communities Act of 2014”) and Representative Tim Murphy (R-PA; “Helping Families in Mental Health Crisis Act”) each have proposed very different visions for the future of America’s mental healthcare. To help us identify the very best features of these two bills, we may wish to consider our inalienable rights from the Declaration of Independence.
• Which features of these bills promote life, including the right to good health? Clearly, we want to foster very effective systems of mental healthcare, fully embedded in our local communities. We want recovery-oriented and trauma-informed community systems that incorporate a full range of services, from prevention to peer-operated warm lines to respite and residential beds. We also want these services to be fully-integrated with primary care and social support services.
• Which features of these bills promote liberty, including personal freedom? Clearly, we want local systems of mental health care that are fully person-centered and that are grounded in shared decision-making, included supported decision-making. As fully as possible, a major goal of care needs to be self-management of illness and health.
• Which features of these bills promote the active pursuit of happiness? We want local systems of mental health care that actively seek, advance, and support a full life in the community for everyone. They must include job, housing, and social supports to facilitate the broad achievement of this goal.
An essential related comment also must be aired. The availability of guns, especially pistols and assault rifles, is an extreme public health crisis in the United States. Witness the tragedy of more than a dozen deaths and mulitple shootings in Chicago over the Independence Day weekend. Careful work in other countries, notably the U.K. and Australia, shows that reducing the number of guns on the street translates into a dramatic decline in the number of shootings. Gun violence is principally a public health crisis of gun availability, not primarily related to mental illness.
Indeed, active pursuit of the three inalienable rights through dramatic improvements to our local mental health systems is a very tall order. It will require our highest and best efforts, as well as those of federal, state, county, and city governments. To coordinate these efforts effectively, we will need a White House Office of Mental Health Policy, and we will need the direct involvement of the president.
Mr. Jefferson would be very pleased!